Substance-Use and Psychiatric Disorders among American Indian Veterans

Howard, Matthew O.; Walker, Robert; Suchinsky, Richard T.; Anderson, B.

doi:10.3109/10826089609045828

Cited by 40 publications

(5 citation statements)

References 27 publications

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“…However, a relatively low prevalence of anxiety and affective disorders combined with a high prevalence of substance use disorders has been reported in SWC Indians (Gilder et al, 2004). Higher rates of substance use disorders and equal or lower rates of “other psychiatric illness” have also been reported in four other studies of Native Americans (Howard et al, 1996; Kasprow and Rosenheck, 1998; Walker et al, 1994). …”

Section: Introductionsupporting

confidence: 62%

Externalizing disorders in American Indians: Comorbidity and a genome wide linkage analysis

Ehlers

Gilder

Slutske

et al. 2008

American J of Med Genetics Pt B

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Alcohol dependence is one of the leading causes of morbidity and mortality in Native Americans. Externalizing disorders such as conduct disorder (CD) and antisocial personality disorder (ASPD) have been demonstrated to have significant comorbidity with alcohol dependence in the general population. This study's aims were to: assess the comorbidity of DSM-III-R ASPD and CD with alcohol dependence, to map susceptibility loci for ASPD and CD, and to see if there is overlap with loci previously mapped for alcohol dependence phenotypes in 587 American Indians. Alcohol dependence was found to be comorbid with DSM-III-R ASPD but not CD. However, the amount of alcohol dependence in the population attributable to ASPD and/or CD is low. ASPD and the combined phenotype of participants with ASPD or CD were both found to have significant heritability, whereas no significant evidence was found for CD alone. Genotypes were determined for a panel of 791 micro-satellite polymorphisms in 251 of the participants. Analyses of multipoint variance component LOD scores, for ASPD and ASPD/CD, revealed six locations that had a LOD score of 2.0 or above: on chromosome 13 for ASPD and on chromosomes 1,3,4,14,17 and 20 for ASPD/CD. These results corroborate the importance of several chromosomal regions highlighted in prior segregation studies for externalizing diagnoses. These results also further identify new regions of the genome, that do not overlap with alcohol dependence phenotypes previously identified in this population, that may be unique to either the phenotypes evaluated or this population of American Indians.

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Section: Introductionsupporting

confidence: 62%

Externalizing disorders in American Indians: Comorbidity and a genome wide linkage analysis

Ehlers

Gilder

Slutske

et al. 2008

American J of Med Genetics Pt B

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“…Among the 72 eligible studies, 35 studies used administrative data and sampled a total of 18,342,443 US veterans . Table provides sample details for the 35 studies that used VA administrative data (SUD ICD‐9 diagnostic codes) to examine the prevalence of SUDs reported in studies sampling US veterans accessing VA care.…”

Section: Resultsmentioning

confidence: 99%

The epidemiology of substance use disorders in US Veterans: A systematic review and analysis of assessment methods

et al. 2015

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Background Substance use disorders (SUDs), which encompass alcohol and drug use disorders (AUDs, DUDs), constitute a major public health challenge among US veterans. SUDs are among the most common and costly of all health conditions among veterans. Objectives This study sought to examine the epidemiology of SUDs among US veterans, compare the prevalence of SUDs in studies using diagnostic and administrative criteria assessment methods, and summarize trends in the prevalence of SUDs reported in studies sampling US veterans over time. Methods Comprehensive electronic database searches were conducted. A total of 3,490 studies were identified. We analyzed studies sampling US veterans and reporting prevalence, distribution, and examining AUDs and DUDs. Results Of the studies identified, 72 met inclusion criteria. The studies were published between 1995 and 2013. Studies using diagnostic criteria reported higher prevalence of AUDs (32% vs. 10%) and DUDs (20% vs. 5%) than administrative criteria, respectively. Regardless of assessment method, both the lifetime and past year prevalence of AUDs in studies sampling US veterans has declined gradually over time. Conclusion The prevalence of SUDs reported in studies sampling US veterans are affected by assessment method. Given the significant public health problems of SUDs among US veterans, improved guidelines for clinical screening using validated diagnostic criteria to assess AUDs and DUDs in US veteran populations are needed. Scientific Significance These findings may inform VA and other healthcare systems in prevention, diagnosis, and intervention for SUDs among US veterans.

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“…Yet, an uninformed clinician might view this complaint as only a cognitive distortion caused by PTSD. Another complication in the assessment of PTSD in some of these communities is accounting for the high prevalence of alcohol abuse and dependence (Walker, Howard, Anderson, & Lambert, 1994), which may be comorbid with PTSD (Howard, Walker, Suchinsky, & Anderson, 1996), increase vulnerability for PTSD (Westermeyer, 2001), or make PTSD harder to detect. These issues may make differential diagnosis particularly difficult in this population.…”

Section: Treatment Considerations For American Indian Ptsd Patientsmentioning

confidence: 99%

Posttraumatic stress disorder among ethnoracial minorities in the United States.

Pole¹,

Gone²,

Kulkarni³

2008

Clinical Psychology: Science and Practice

183

200

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Because ethnoracial minorities are a growing part of the U.S. population yet are underrepresented in the psychopathology literature, we reviewed the evidence for differences in prevalence and treatment of posttraumatic stress disorder (PTSD) in African Americans, Latino Americans, Asian and Pacific Islander Americans, and American Indians. With respect to prevalence, Latinos were most consistently found to have higher PTSD rates than their European American counterparts. Other groups also showed differences that were mostly explained by differences in trauma exposure. Many prevalence rates were varied by subgroup within the larger ethnoracial group, thereby limiting broad generalizations about group differences. Regarding service utilization, some studies of veterans found lower utilization among some minority groups, but community-based epidemiological studies following a traumatic event found no differences. Finally, in terms of treatment, the literature contained many recommendations for culturally sensitive interventions but little empirical evidence supporting or refuting such treatments. Taken together, the literature hints at many important sources of ethnoracial variation but raises more questions than it has answered. The article ends with recommendations to advance work in this important area.

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Substance-Use and Psychiatric Disorders among American Indian Veterans

Cited by 40 publications

References 27 publications

Externalizing disorders in American Indians: Comorbidity and a genome wide linkage analysis

Externalizing disorders in American Indians: Comorbidity and a genome wide linkage analysis

The epidemiology of substance use disorders in US Veterans: A systematic review and analysis of assessment methods

Posttraumatic stress disorder among ethnoracial minorities in the United States.

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